About the service:

Chaseview Care Home is a residential care home providing accommodation and personal care to 97 people, at the time of the inspection.

People’s experience of using this service:

• Some people, relatives and staff raised concerns with staffing levels. We found a number of issues with staffing, which included delay in call bell response and ineffective staff deployment in units.

• Some staff raised concerns with lack of support given by the management team. Supervisions were not regular to ensure staff were supported at all times. This was being addressed. We made a recommendation in this area.

• Care plans were inconsistent especially in the area of skin integrity to ensure people were in the best of health and received person centred care. We made a recommendation in this area.

• Audits had not identified the shortfalls we found during the inspection especially with staffing.

• People received their medicines as prescribed and medicines records were completed accurately. However, there was lack of robust systems in place to review people’s medicine’s annually. We made a recommendation in this area.

• Risks associated with people’s needs had been assessed.

• Staff had completed essential training to perform their roles effectively.

• People were supported with their nutritional needs and had choices with meals. However, people and relatives expressed concerns with meals and the timing of meals. We made a recommendation in this area.

• The staff worked well with external health care professionals and people were supported with their needs and accessed health services when required.

• People continued to receive care from staff who were kind and compassionate. Staff treated people with dignity and respected their privacy.

• Staff had developed positive relationships with the people they supported. They understood people’s needs, preferences, and what was important to them.

• People’s independence was promoted.

• We identified two breaches of Regulations associated with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

• Full information about CQC’s regulatory response to the more serious concerns found in inspections and appeals is added to reports after any representations and appeals have been concluded.

• For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection:

• At the last inspection on 5 and 6 February 2019 the service was rated ‘Requires Improvement’. At this inspection, the rating for the service continuous to be ‘Requires Improvement’.

• At our last inspection, the service was in breach of three Regulations associated with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to staffing, risk management and restricting people’s liberty lawfully. At this inspection, breaches relating to risk management and restricting people’s liberty lawfully had been addressed. However, concerns remained with staffing.

Why we inspected:

• This was a planned inspection based on the rating of the last inspection.

Follow up:

• We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care. Further inspections will be planned for future dates.

We carried out an unannounced inspection of Chaseview Care Home on 5 and 6 February 2018. Chaseview Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Chaseview Care Home is a care home for up to 120 older adults. This included people with dementia and people who were at the home for a short stay. The home was split across four units and each unit was managed by a unit manager. There were 100 people living at the home on 5 February 2018, which had reduced to 99 people on the second day of the inspection.

The home had recently changed providers and this was the first inspection since the new provider took over.

The home had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the home. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the home is run.

Risk assessments for most people who lived in the home included information on how to mitigate identified risks. However, risks were not always robustly managed for some people to ensure they were safe at all times.

Some people, relatives and staff raised concerns about staffing levels. The way staff were deployed across the home meant there were sometimes delays in providing support to people who required it.

Some people who lived at the home were deprived of their liberty under the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). Deprivation of Liberty applications had not been made for four people when their initial DoLS authorisation had expired. Staff were aware of the principles of the MCA and assessments had been carried out to determine people’s ability to make decisions in certain areas.

Quality assurance systems were in place but were not always effective. The audits which the home carried out had not identified the shortfalls we found during the inspection to ensure people were safe at all times. Accurate and complete records had not been kept to ensure people received high quality care and support.

Medicines were managed safely. In general, we found that people’s Medicine Administration Records (MAR) had been completed accurately. Medicines was being administered as instructed on people’s MAR, or in accordance with the provider’s policy.

Pre-employment checks had been carried out for new staff to ensure they were suitable to provide care and support to people safely. Staff we spoke to were aware of how to identify abuse and knew who to report abuse to, both within the organisation and externally.

Incident records were reviewed and these showed the provider took appropriate action following incidents that had been recorded. Systems were in place to analyse incidents for patterns and trends to ensure lessons were learnt and incidents were minimised.

Systems were in place to reduce the risk and spread of infection. Staff had access to personal protective equipment and used this when needed.

Staff had the skill and knowledge to provide support effectively. Records showed that some staff needed refresher training in some areas. This was being addressed by the management team. Staff were knowledgeable on how to support people. Supervisions were carried out regularly and staff told us that they were supported by the manager.

People had access to healthcare services and staff knew what to do if people felt unwell.

People in general told us that they enjoyed the food at the home and were given choices. However, people in one unit raised concerns with meals. People’s weight and food intake was monitored when required and if there were concerns, action was taken, which resulted in people’s health improving.

Care